InNeedOfHope Posted November 12, 2011 Share Posted November 12, 2011 (edited) ADMIN NOTE See: Steady State Diagram Diagram has been copied from this site. I am new to this site, but am desperate. I have a question. I only know about SRNI's and think that they are especially evil due to the additional neurotransmitter targeted. Can some people be so sensitive to the short half life that they cannot withdraw? That they are continually in servere withdrawal as the carry on taking it because their body cries out for more within the course of each day. Does the stress of this type of severe withdrawal prevent the brain from healing, as it is in shock every day? So a vicious circle exists? I know that everyones symptoms are different as is the severity. I suppose I am looking for an answer from someone like me who has it had it very severe physically, someone who was on a medicine with a short half life, who had symptoms if they were even a tiny bit late taking it. What did you do? Am I wrong in my thinking. Do I just need time? Can this be done? Edited January 1, 2022 by Altostrata added link Sept 2010 - Citalopram 1 day Sept 2010 - Zopliclone for ten weeks (paranoia ended a couple of months after coming off this and sleep settled down again until the last couple of months) Ocober 2010 - Cymbalta 30mg November 2010 - Cymbalta 60mg February 2011 - 60mg to 30 mg (lasted 10 days)reinstated 60mg March 2011 - Took 2 60mg tablets on one evening in error - paralysis of face, back of head, shoulder, stabbing in right kidney, lost 30% of hearing) March - June 2011 went down quickly 1mg a day until I got stuck at 25mg, went up to 27mg, because couldn't breath. 26th June - 26mg 3rd July - 25mg 17th July - 24mg 24th July - 23mg 7th Aug - began reducing by a bead every couple of days or so went well at first then hit a wall 24th October - now on 18.5mg. Since the kidney infection at start of September, have been in constant pain and anxiety, no let up. Given Ciprofloxacin. 8th Jan 2012 17.8mg (currently reducing 0.2mg a week) 8th Jan 2012 17.6mg last reduction was 6 days ago. 15th Jan 17.4mg 21st Jan 17.2mg Link to comment Share on other sites More sharing options...
Barbarannamated Posted November 12, 2011 Share Posted November 12, 2011 I am new to this site, but am desperate. I have a question. I only know about SRNI's and think that they are especially evil due to the additional neurotransmitter targeted. Can some people be so sensitive to the short half life that they cannot withdraw? That they are continually in servere withdrawal as the carry on taking it because their body cries out for more within the course of each day. Does the stress of this type of severe withdrawal prevent the brain from healing, as it is in shock every day? So a vicious circle exists? I know that everyones symptoms are different as is the severity. I suppose I am looking for an answer from someone like me who has it had it very severe physically, someone who was on a medicine with a short half life, who had symptoms if they were even a tiny bit late taking it. What did you do? Am I wrong in my thinking. Do I just need time? Can this be done? InNeed, I'm sorry that you are suffering so horribly. You are right in that each of us is different. We are different even from ourselves at various times. I was on Effexor XR for several years after being on short acting Effexor. If I missed one dose, I would feel it that day w/dizziness, brain zaps, etc. I can't imagine how terrible it must be to have the excruciating whole body pain and the additional anxiety of having to keep such a tight schedule of taking your meds. Some people are "fast metabolzers"--their enzymes process meds more quickly. Cymbalta also has a very tricky metabolism that I won't pretend to understand. I switched from Effexor XR to Pristiq a few years ago. The drugs are very similar, from what I understand. However, I did not get the immediate WD effects w/Pristiq that I got with Effexor and I have no idea why. I'm not suggesting that another drug should be tried, but want you to know that it IS possible for it to get easier. Try to separate out what is effecting you right this moment (pain) from the fear of what might happen in the future (the 'what-ifs?'). I know how very difficult this is to do! I will check back in a little later. Barb Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc). Link to comment Share on other sites More sharing options...
InNeedOfHope Posted November 12, 2011 Author Share Posted November 12, 2011 Thank you for your reply. I have become phobic about all medicines, supplements and even foods. In some ways I have learnt to cope with certain aspects. Yesterday and the day before my bladder was in excruiciating pain and I need the toilet every fifteen minutes. I did a dip stick test and the result was a trace hardly there.So I kept calm thinking it may pass and be withdrawal. This was the night after changing my usual pattern of taking the pill after food, I took it on an empty stomach (had no choice that day) but will avoid that at all costs in the future. Today the pain is there in a minimal way in the bladder and kidney, but I am burning like I am on fire and every nerve ending is raw, with severe head pain, chest pain and difficulty breathing. Took my tablet a little late last night. I fear I have gone too fast in the earlier stages and now can't seem to correct, today I don't think I have felt as bad physically in all my life, I am clinging on by reading everything I can on this site. I am trying hard to stay in the day, as I know this has helped me in the past, but it is difficult when I feel the pain getting worse day by day. I know I need to stay calm, but even normal things like the kids arguing is ramping up my pain and anxiety. I am praying that if I hold at this dose even for a while it will change, but feel in a kind of spiral. Thinking of getting a scale to weigh medicine. I don't know what I would do without the support of the charity who help me or websites to read like this one. I have heard of Pristiq but don't know what it is. Some of the best things I have been told by doctors and pharmacists are: "It gets easier the lower you go as at a lower dose it is not doing anything" "It is really just like a bad headache" "Foods do NOT cause pain it is in your head" "If you don't eat properly (bearing in mind I am shovelling food in every hour and a half) you have weeks to live" "I take people on and off these drugs in a couple of weeks, you are just anxious and need more" I think of doctors in this way now : A couple of centuries ago people used to let doctors drill holes in their heads for headaches or blood let or have other drastic procedures. We think how could they have done that? Were they stupid? That misguided. I think this is how psychiatric medicine will be viewed in the future, when really mental illnesses in my mind are a result of nutritional imbalances and a environmental toxins and a lack of humanity in society. Sorry to go on, I guess I am trying to distract from my pain. Sept 2010 - Citalopram 1 day Sept 2010 - Zopliclone for ten weeks (paranoia ended a couple of months after coming off this and sleep settled down again until the last couple of months) Ocober 2010 - Cymbalta 30mg November 2010 - Cymbalta 60mg February 2011 - 60mg to 30 mg (lasted 10 days)reinstated 60mg March 2011 - Took 2 60mg tablets on one evening in error - paralysis of face, back of head, shoulder, stabbing in right kidney, lost 30% of hearing) March - June 2011 went down quickly 1mg a day until I got stuck at 25mg, went up to 27mg, because couldn't breath. 26th June - 26mg 3rd July - 25mg 17th July - 24mg 24th July - 23mg 7th Aug - began reducing by a bead every couple of days or so went well at first then hit a wall 24th October - now on 18.5mg. Since the kidney infection at start of September, have been in constant pain and anxiety, no let up. Given Ciprofloxacin. 8th Jan 2012 17.8mg (currently reducing 0.2mg a week) 8th Jan 2012 17.6mg last reduction was 6 days ago. 15th Jan 17.4mg 21st Jan 17.2mg Link to comment Share on other sites More sharing options...
Shanti Posted November 12, 2011 Share Posted November 12, 2011 I am new to this site, but am desperate. I have a question. I only know about SRNI's and think that they are especially evil due to the additional neurotransmitter targeted. Can some people be so sensitive to the short half life that they cannot withdraw? That they are continually in servere withdrawal as the carry on taking it because their body cries out for more within the course of each day. Does the stress of this type of severe withdrawal prevent the brain from healing, as it is in shock every day? So a vicious circle exists? I know that everyones symptoms are different as is the severity. I suppose I am looking for an answer from someone like me who has it had it very severe physically, someone who was on a medicine with a short half life, who had symptoms if they were even a tiny bit late taking it. What did you do? Am I wrong in my thinking. Do I just need time? Can this be done? Hi InNeed, I started having the physical symptoms of withdrawals while at my full dose of Paxil. Paxil has a very short half life. This is what made me decide to go off it. It was so severe with the brain zaps, twitches and jerks that I had an EEG. While on the EEG, I did have zaps and jerks and they didn't show up on the EEG. I've been having them for months and it hasn't caused any damage. I've read many success stories from people coming off these meds with severe symtpoms and they are doing fine now. Here's a link to some at my website. Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012. Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38) My Paxil Website My Intro Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted November 12, 2011 Administrator Share Posted November 12, 2011 InNeed, half-life has something to do with withdrawal but it's not the whole story. Some people are more sensitive than others when they reduce these medications. Medicine is complacent about how easy withdrawal is. Many doctors don't understand that the rate of tapering is individual, and some people have to go very, very slowly. There is a lot of misinformation among doctors and druggists. I am trying to find doctors who grasp the problem of withdrawal. David Healy in Wales is one of them. He had done a lot of courageous publishing and speaking on the issue. Withdrawal can be done, but we have seen Paxil, Effexor, and now Cymbalta can be extremely difficult to taper off of. It's very important to stay calm and don't panic. When you stir yourself up to a peak of worrying, you make your symptoms worse. We suggest practicing breathing meditation to calm the nervous system. You will need to stay calm so you can take care of yourself and heal. I've suggested you contact Dr. Healy and see if he can help you or refer you to a doctor nearer you. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted November 17, 2011 Administrator Share Posted November 17, 2011 Switching to Prozac is indeed a method to taper off a short half-life antidepressant. I moved the Prozac switch discussion here -- to its own topic. Thanks for adding this information, Strawberry. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Moderator Emeritus Rhiannon Posted November 30, 2011 Moderator Emeritus Share Posted November 30, 2011 Ciprofloxacin interacts with GABA receptors (blocks them) and causes nasty symptoms in people struggling with benzo withdrawal. I wouldn't be surprised if GABA receptors are part of the picture with Cymbalta, given how drastic its effects are and how hard it is to get off of. Plus, as you know, all neurotransmitter systems are connected and affect each other. Could be part of the story. Given your history you might see if your doc will help you avoid the fluoroquinolone family of antibiotics. Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. Started multidrug taper in Feb 2010. Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea. Feb 15 2010: 300 mg Neurontin 200 Lamictal 10 Celexa 0.65 Xanax and 5 mg Ambien Feb 10 2014: 62 Lamictal 1.1 Celexa 0.135 Xanax 1.8 Valium Feb 10 2015: 50 Lamictal 0.875 Celexa 0.11 Xanax 1.5 Valium Feb 15 2016: 47.5 Lamictal 0.75 Celexa 0.0875 Xanax 1.42 Valium 2/12/20 12 0.045 0.007 1 May 2021 7 0.01 0.0037 1 Feb 2022 6 0!!! 0.00167 0.98 2.5 mg Ambien Oct 2022 4.5 mg Lamictal (off Celexa, off Xanax) 0.95 Valium Ambien, 1/4 to 1/2 of a 5 mg tablet I'm not a doctor. Any advice I give is just my civilian opinion. Link to comment Share on other sites More sharing options...
Barbarannamated Posted November 30, 2011 Share Posted November 30, 2011 Is that secondary to myelin sheath Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc). Link to comment Share on other sites More sharing options...
Moderator Emeritus areyouthere Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 What are and how do "metabolites" of drugs have anything to do with withdrawal? Thanks. RU Fall 1995 xanax, zoloft. switched to Serzone 1996- spring 2003serzone/ xanax/ lightbox. b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b] 2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax My mantra " go slow & with the flow " 3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day) 4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day. 10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro. 1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms. 1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut. Link to comment Share on other sites More sharing options...
Moderator Emeritus Skyler Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 What are and how do "metabolites" of drugs have anything to do with withdrawal? Thanks. RURU, are you asking this because you heard them referred to when describing benzos? How about posting this thread in the benzo section, or maybe one of the admins can move it there.... As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule. Requip - 3/16 ZERO Total time on 25 years. Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.BENZO FREE 10/13 (started tapering 7/10) Total time on 25 years. Read my intro thread here, and check the about me section. "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin Link to comment Share on other sites More sharing options...
Moderator Emeritus areyouthere Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 Not sure where I read it on the forum.... but yah... move it if need be. Fall 1995 xanax, zoloft. switched to Serzone 1996- spring 2003serzone/ xanax/ lightbox. b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b] 2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax My mantra " go slow & with the flow " 3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day) 4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day. 10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro. 1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms. 1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut. Link to comment Share on other sites More sharing options...
Moderator Emeritus Skyler Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 Seems like it's time for you to start reading up diazepam. Not sure where I read it on the forum.... but yah... move it if need be.You saw it mentioned in conjunction with diazepam. I'm a tad confused as to the reason you asked about metabolites when you did not know what drug category (benzos) you were referencing? I'm not the one who can move this thread, but one of the staff can do so. As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule. Requip - 3/16 ZERO Total time on 25 years. Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.BENZO FREE 10/13 (started tapering 7/10) Total time on 25 years. Read my intro thread here, and check the about me section. "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin Link to comment Share on other sites More sharing options...
Moderator Emeritus Skyler Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 Ohhh, I think this may be the post you are referencing (mia culpa). This is kind of a big question. Still, take a stab at it by reading up on diazepam? As everyone knows here, I am not a doctor. flower, I believe I told you several times if taking Celexa makes you feel worse, DO NOT INCREASE IT. I also mentioned Celexa may be conflicting with trazodone's nasty metabolite mCPP (not gabapentin). I believe it was RebelMaven who had this problem. Increasing Celexa will increase the problem with mCPP, which can cause many uncomfortable symptoms emerging when you take Celexa in the morning. If I were you, I might REDUCE THE TRAZODONE slightly and see if the symptoms get better. If you're taking Vistaril to get some sleep, the trazodone isn't helping there anyway. As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule. Requip - 3/16 ZERO Total time on 25 years. Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.BENZO FREE 10/13 (started tapering 7/10) Total time on 25 years. Read my intro thread here, and check the about me section. "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin Link to comment Share on other sites More sharing options...
Moderator Emeritus Jemima Posted December 15, 2012 Moderator Emeritus Share Posted December 15, 2012 Definition of metabolite: metabolite /me·tab·o·lite/ (-līt) any substance produced by metabolism or by a metabolic process. Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc. All rights reserved. me·tab·o·lite (m-tb-lt) n. 1. A substance produced by metabolism. 2. A substance necessary for or taking part in a particular metabolic process. The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved. As for the question about what metabolites have to do with drug withdrawal, I haven't got a clue. Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's RazorIntroduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/ Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers. Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted December 16, 2012 Administrator Share Posted December 16, 2012 As drugs get metabolized, natural processes break them down. The results are metabolites -- chemical relatives of the original drug. Eventually, they are excreted. The understanding of the metabolic stages of a drug is called pharmacokinetics. Many metabolites are inactive, having no effect on any body processes. Others are active. Active metabolites may cause odd reactions, adverse effects, or have similar effects to the original drug. Active metabolites may conflict with other drugs and their metabolites. In psychiatric drugs, active metabolites may extend the half-life of the drug, as it can take additional metabolism to break them down further. Metabolites can have metabolites of their own, some of them being active, too. Estimating half-life with active metabolites creating other active metabolites can be very confusing. Often, the half-life of drugs with active metabolites, is expressed as a wide range. For example: Amitriptyline The overlapping metabolism of amitriptyline and its 2 active metabolites nortriptyline and 10-hydroxynortriptyline is probably why it's so difficult to estimate the half-life of this medication: amitriptyline (10-26 hrs) ---> nortriptyline (18-44 hrs) ---> 10-hydroxynortriptyline (8-10 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/1099-tips-for-tapering-off-amitriptyline/ ) Trazodone Trazodone itself takes 3-6 hours to break down into its metabolites. One active metabolite is mCPP, with a half-life of 2-6 hours. While trazodone may make you sleepy, mCPP has the opposite effect, sometimes very unpleasantly. trazodone (3-6 hrs) ---> mCPP (2-6 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/2883-tips-for-tapering-off-trazodone-desyrel/ ) Effexor (venlafaxine) Regular-release Effexor has a half-life of about 4 hours; its active metabolite, O-desmethylvenlafaxine or desvenlafaxine, has a half-life of 10 hours. Pristiq is made from desvenlafaxine. venlafaxine (4 hrs) ---> desvenlafaxine (10 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/ ) Prozac (fluoxetine) Prozac has an active metabolite, norfluoxetine; fluoxetine and norfluoxetine inhibit each other's metabolism extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks. fluoxetine (1-6 days) ---> norfluoxetine (up to 16 days) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine ) 1 This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Moderator Emeritus areyouthere Posted December 16, 2012 Moderator Emeritus Share Posted December 16, 2012 As drugs get metabolized, natural processes break them down. The results are metabolites -- chemical relatives of the original drug. Eventually, they are excreted. The understanding of the metabolic stages of a drug is called pharmacokinetics. Many metabolites are inactive, having no effect on any body processes. Others are active. Active metabolites may cause odd reactions, adverse effects, or have similar effects to the original drug. Active metabolites may conflict with other drugs and their metabolites. In psychiatric drugs, active metabolites may extend the half-life of the drug, as it can take additional metabolism to break them down further. Metabolites can have metabolites of their own, some of them being active, too. Estimating half-life with active metabolites creating other active metabolites can be very confusing. Often, the half-life of drugs with active metabolites, is expressed as a wide range. For example: Amitriptyline The overlapping metabolism of amitriptyline and its 2 active metabolites nortriptyline and 10-hydroxynortriptyline is probably why it's so difficult to estimate the half-life of this medication: amitriptyline (10-26 hrs) ---> nortriptyline (18-44 hrs) ---> 10-hydroxynortriptyline (8-10 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/1099-tips-for-tapering-off-amitriptyline/ ) Trazodone Trazodone itself takes 3-6 hours to break down into its metabolites. One active metabolite is mCPP, with a half-life of 2-6 hours. While trazodone may make you sleepy, mCPP has the opposite effect, sometimes very unpleasantly. trazodone (3-6 hrs) ---> mCPP (2-6 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/2883-tips-for-tapering-off-trazodone-desyrel/ ) Effexor (venlafaxine) Regular-release Effexor has a half-life of about 4 hours; its active metabolite, O-desmethylvenlafaxine or desvenlafaxine, has a half-life of 10 hours. Pristiq is made from desvenlafaxine. venlafaxine (4 hrs) ---> desvenlafaxine (10 hrs) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/ ) Prozac (fluoxetine) Prozac has an active metabolite, norfluoxetine; fluoxetine and norfluoxetine inhibit each other's metabolism extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks. fluoxetine (1-6 days) ---> norfluoxetine (up to 16 days) ---> other metabolites (See http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine ) Thank you. Fall 1995 xanax, zoloft. switched to Serzone 1996- spring 2003serzone/ xanax/ lightbox. b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b] 2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax My mantra " go slow & with the flow " 3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day) 4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day. 10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro. 1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms. 1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut. Link to comment Share on other sites More sharing options...
Mentor Happy2Heal Posted January 14, 2017 Mentor Share Posted January 14, 2017 (edited) can someone tell me what it means when a drug has a half life of say, 32 hrs? does that mean it's still having an effect on you for at least 32 hrs after taking a dose? if you take a dose in 24 hrs after the first one, does the effect accumulate, because the part of the first dose is still affecting you? Edited July 21, 2017 by Altostrata merged topics and retitled Taking a break from mentoring, please do not message or tag me, thank you! Got some personal stuff to deal with and am not able to give you my full attention. I will remove this reminder when I am back. Keep on swimming, my friends. 😊 pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total) Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years started lexapro 2002, dose varied from 20mgs to 40mgs. First attempt to get off it was 2007- WD symptoms were mistaken for "relapse". 2013 too fast taper down to 5mg but WD forced me back to 20mgs June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". felt ok until Sept, then acute WD hit!! reinstated at 0.3mgs in Oct. 2106 Tapered off to zero by Oct. 2017 Doing very well. Nov. 2018 feel 95% healed, age 63 Jan. 2020 feel 100% healed, peaceful and content PRESENT DAYS: Loving life! ❤️ with all it's ups and downs Link to comment Share on other sites More sharing options...
nz11 Posted January 14, 2017 Share Posted January 14, 2017 (edited) Great question H2H The half life is the period of time required for the amount [concentration] of drug in the body to be reduced by one-half. if you take a dose in 24 hrs after the first one, does the effect accumulate, because the part of the first dose is still affecting you? you're onto it H2H! I just looked up half-life of zyprexa and it says 30 hours. So i guess thats close to 32 so i assume you are referring to zyprexa's half life here. What this means is that if one takes a 2.5 mg tablet then it will take 30 hours (1.5 days) (lets go with 30 hrs it makes things easy(er)...you'll see in a minute), for the amount of zyprexa in the blood to fall to 1.25mg However thats not what will be in the blood cos in the meantime you just swallowed another one. I'm not an expert in this so dont hold me to anything here but lets have a look at whats going on based on the defn of half life. This is also slightly tricky cos we want to find out how much drops out in 24 hrs not 30 hrs so by ratio i would assume its equivalent to a drop of 1mg after 24 hrs So levels in your blood i assume go like this... day 1 2.5mg total in blood 2.5mg day 2 2.5( another 2.5 is swallowed), 1.5 (day one's dose has now dropped 1mg to 1.5mg) total 4.0 mg in blood day 3 2.5, 1.5, 0.5 (day ones dose is now dropped to 0.5) total 4.5 day4 2.5, 1.5, 0.5, - (day ones dose has now gone) total 4.5mg day5 2.5, 1.5, 0.5, - total 4.5 mg etc Note how after three days there is now a constant amount of 4.5mg in the blood. A steady state now exists. ie the introduction of the drug keeps pace with its removal. This is why the moderators will tell you it takes about 4 days for the drug to reach a steady state in the blood. I've made one or two wee assumptions here so it could be oversimplified....but i think this is basically it. nz11 edit: I just posted and i see that Lex posted in the meantime. Sorry for the doubleup. Edited March 30, 2022 by ChessieCat changed member name Thought for the day: Lets stand up, and let’s speak out , together. G Olsen We have until the 14th. Feb 2018. URGENT REQUEST Please consider submitting for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing. http://www.parliament.scot/GettingInvolved/Petitions/PE01651 Please tell them about your problems taking and withdrawing from antidepressants and/or benzos. Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you Recovering paxil addict None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped." Dr Mosher. Me too! Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015 I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015 Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017 Link to comment Share on other sites More sharing options...
Sertralinsomnia Posted February 23, 2017 Share Posted February 23, 2017 I was wondering, i dont know very much about half lifes of meds and steady states, etc. But i am curious on something, lets take zoloft for example, it has a half life of 24 to 26 hours. this would mean that if you take 50 mg today, tomorrow you would still have 25 mg in your blood, but tomorow you would take another 50 mg tablet, if the half life of the first pill is still there, it would mean that on the second day, we would have 75 mg of zoloft in our blood right? And then Since they are separate doses, they half lives would vanish indepedently, if so it would accumulate, i am missing something here, sorry for my curiosity., can someone explain how this reallly works? According to what i understand this simple table shows that at the seventh day we would still have 98,8 mg on blood? The numbers separated from / are the half lives of the pill from the day before. DAY 1 2 3 4 5 6 7 DOSE 50 25/50 = 75 mg 12.5/25/50 = 87,5 mg 6.25/12.5/25/50 = 93,75 mg 3.2/6.25/12.5/25/50 = 93,95 1.2/3.25/6.25/12.5/25/50 = 98,2 mg 0.6/1.2/3.25/6.25/12.5/25/50 = 98,8 mg So this would mean a dose of 50 every day would mean that a steady state is double the dose we take every day? If so that is way to huge. ???? Since i am only taking 2 mg a day, my steady state is in fact the double of it: DAY 1 2 3 4 5 6 7 dose 2 1/2 0.5/1/2 0.25/0.5/1/2 0.125/0.25/0.5/1/2 0.06/0.125/0.25/0.5/1/2 0.03/0.06/0.125/0.25/0.5/1/2 = 3.965 mg Started zoloft 25 mg on October 2009. Started tapering May 2016 to june 2016, last week at 12,5 mg and quitCrashed 23 january 2017, severe headache and panic (never had this panic all my life) next morning.Tried to reinstate with prozac 5 mg a day on 25 January 2016, bad choice, got arrhytmias and stopped. Started propranolol 40 mg as needed on january23 - 28 Feb 2017 Tried zoloft reinstatement at 1mg didnt work, more akathisia and head pressure. Link to comment Share on other sites More sharing options...
Moderator Emeritus scallywag Posted February 24, 2017 Moderator Emeritus Share Posted February 24, 2017 I posted a chart with the half-lives for Cymbalta, the medication I'm taking, in this post in my intro topic. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to 0.0 mg Aug. 12; details here scallywag's IntroductionOnline spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet Link to comment Share on other sites More sharing options...
Moderator Emeritus scallywag Posted July 15, 2017 Moderator Emeritus Share Posted July 15, 2017 The body is continually metabolizing the medication, even after the first half-life has expired. The approved and published daily maximium dose for a medication takes into account the ability of the body to metabolize that medication so that repeated daily doses do not lead to toxicity. This area of knowledge is called "pharmacokinetics." If other medications are taken during the day, the capacity to metabolize may be affected. This is why we urge people taking more than one drug to obtain and post an interactions report. Drugs-dot-com Drugs Interactions Checker. If you want to delve into these questions further, a web search using keywords "drug name " and "pharmacokinetics " This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to 0.0 mg Aug. 12; details here scallywag's IntroductionOnline spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet Link to comment Share on other sites More sharing options...
arwilliams Posted June 4, 2018 Share Posted June 4, 2018 How do injections factor in to half life? For example is the in dosage as high as a weeks dosage to the brain and get even crazy during an injection(considering lots of injections are for a week)? Does the injection release the drug slowly with a special chemical maybe? Just to add there appears to be long lasting and short lasting injections. Also do some basic logic a drug with a 33 hour half life will be 50% or 2.5 mg at a 33 hours. Does that mean I could stagger dosages to get a more consistent dosage across the day but still have the same dosage over several hours? My Intro FB Zyprexa 2015-September 2018 1st time I tried to come straight off of 10mg Zyprexa I was hospitalized for insane insomnia. Current - Abilify Maintena & L Theanine(for akathisia) Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted June 5, 2018 Administrator Share Posted June 5, 2018 Merged related topics. The liquid in a drug injection is not timed-release. Most injections deliver a very high initial dosage of the drug, the dosage being calibrated to take X days for metabolization. The drug in an injection is not released slowly. Adverse effects are highest at the time of the injection, then supposedly decrease as the drug is metabolized. Most injectable psychiatric drugs, which are tend to be anti-psychotics with long half-lives and very serious side effects, are timed to for a minimum of 4 weeks. Injectable anti-psychotics are intended for people who cannot be trusted to take their drugs regularly and may be societal problems. The dosing of injectable anti-psychotics is purposely high so as to reliably subdue the patient's behavior. If you get injections of these drugs at shorter intervals than for which they are intended, you will be getting higher, possibly toxic, dosages of these drugs. elevating risk of severe, possibly permanent adverse effects. Think of graphing half-lives of drugs as sloping lines, peaking when the drug is ingested or injected. Overlapping half-lives are additive. Staggering injections of psychiatric drugs at intervals shorter than for which they are designed doesn't make any sense and it is highly unlikely you will find a reputable doctor who will prescribe injections like this. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted March 13, 2019 Administrator Share Posted March 13, 2019 DRUG HALF-LIFE CALCULATOR This is a simple mathematical calculation of the time to washout (0% of the drug left in your bloodstream) based on your drug's half-life. Please note other factors, such as other drugs you're taking or liver condition, will affect the metabolization of a drug, and consider this calculation only an estimate. http://www.drugsdb.com/resources/drug-half-life-calculator/ Look up the "Half Life" of your drug at https://www.drugbank.ca/ This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Moderator Emeritus ChessieCat Posted December 30, 2021 Moderator Emeritus Share Posted December 30, 2021 (edited) This diagram gives a good visual of what happens as a drug is started and gets to steady state. The highest part of the curve is the maximum peak concentration and the lowest part of the curve is the minimum peak concentration. Once the drug is at steady state then the max and min are at a higher concentration than during the first four days of starting the drug. Diagram has been copied from this site. Edited December 30, 2021 by ChessieCat added where diagram from 1 * NO LONGER ACTIVE on SA * MISSION ACCOMPLISHED: (6 year taper) 0mg Pristiq on 13th November 2021 ADs since ~1992: 25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq: 50mg 2012, 100mg beg 2013 (Serotonin Toxicity) Tapering from Oct 2015 - 13 Nov 2021 LAST DOSE 0.0025mg Post 0 updates start here My tapering program My Intro (goes to tapering graph) VIDEO: Antidepressant Withdrawal Syndrome and its Management Link to comment Share on other sites More sharing options...
Recommended Posts